Establishment and molecular characterization of HCB-541, a novel and aggressive human cutaneous squamous cell carcinoma cell line.

Cutaneous squamous cell carcinoma (cSCC) is a common type of skin cancer that can result in significant morbidity, although it is usually well-managed and rarely metastasizes. However, the lack of commercially available cSCC cell lines hinders our understanding of this disease. This study aims to establish and characterize a new metastatic cSCC cell line derived from a Brazilian patient. A tumor biopsy was taken from a metastatic cSCC patient, immortalized, and named HCB-541 after several passages. The cytokeratin expression profile, karyotypic alterations, mutational analysis, mRNA and protein differential expression, tumorigenic capacity in xenograft models, and drug sensitivity were analyzed. The HCB-541 cell line showed a doubling time between 20 and 30 h and high tumorigenic capacity in the xenograft mouse model. The HCB-541 cell line showed hypodiploid and hypotetraploidy populations. We found pathogenic mutations in TP53 p.(Arg248Leu), HRAS (Gln61His) and TERT promoter (C228T) and high-level microsatellite instability (MSI-H) in both tumor and cell line. We observed 37 cancer-related genes differentially expressed when compared with HACAT control cells. The HCB-541 cells exhibited high phosphorylated levels of EGFR, AXL, Tie, FGFR, and ROR2, and high sensitivity to cisplatin, carboplatin, and EGFR inhibitors. Our study successfully established HCB-541, a new cSCC cell line that could be useful as a valuable biological model for understanding the biology and therapy of metastatic skin cancer.

Identification and characterization of plastic debris in the gastrointestinal tract of Guiana dolphins (Sotalia guianensis) from Espírito Santo coast, Brazil.

The Guiana dolphin (Sotalia guianensis) is categorized as vulnerable in the Brazilian list of endangered animals, and its populations suffer from several anthropological threats. In this study, we analyzed the presence of macro, meso, and microplastics (MPs) in Guiana dolphins (n = 12) in Brazil Southeastern coast by analysing their gastrointestinal tract. The MP extractions were carried out with H2O2 (35 %) to remove organic matter. Four specimens ingested meso and macroplastics, including an item of polypropylene of 19.22 cm that was produced about 943 km from the place in which the animal was found stranded. All the specimens analyzed had fragment-type microplastics in their intestines. Blue was the prevailing color, followed by black, green, and red. We highlight the contamination by microplastics in the species, still little investigated, especially the need to understand the contamination by microplastics along trophic levels.

Rapid On-Site Evaluation by Endosonographer of Endoscopic Ultrasound Fine-Needle Aspiration of Solid Pancreatic Lesions: A Randomized Controlled Trial.

OBJECTIVES: Rapid on-site evaluation (ROSE) by cytopathologists during endoscopic ultrasound-fine-needle aspiration (EUS-FNA) of solid pancreatic lesions (SPLs) improves adequacy and diagnostic accuracy while reducing the number of needle passes. We evaluated the usefulness of ROSE performed by the endosonographer. METHODS: Patients with an SPL were randomly assigned to EUS-FNA with ROSE or non-ROSE. Procedure duration, number of needle passes, specimen adequacy, and adverse event rates were compared. RESULTS: Sixty-five patients were enrolled (33 in the ROSE vs 32 in the non-ROSE group). Both groups were similar in terms of age, sex, size, and location of the lesion. Specimen adequacy rates were high and similar between groups. Mean (standard deviation) procedure duration was shorter in the ROSE versus non-ROSE group (30.0 [11.3] vs 37.0 [7.2] minutes, P < 0.005), as well as the mean (standard deviation) number of needle passes (2.6 [0.8] vs 3.5 [0.8], P < 0.005). Accuracy parameters as sensitivity and accuracy of ROSE by the endosonographer for malignancy were 93% and 88%, respectively. CONCLUSIONS: After specific training, the endosonographer can accurately evaluate samples during EUS-FNA of SPL, allowing for a shorter procedure duration and a lower number of needle passes.

Letter to the editor: radiomics analysis for predicting pembrolizumab response in patients with advanced rare cancers.

A commentary on the original research article: 'Radiomics analysis for predicting pembrolizumab response in patients with advanced rare cancers'. Of note, the predictor selection process, the cross-validation method, along with the lack of final testing of the developed model with a separated data set may mask overfitting, overestimating performance metrics.

Near Infrared (NIR) Fluorescence is Not a Substitute for Lymphoscintigraphy and Gamma Probe for Melanoma Sentinel Node Detection: Results from a Prospective Trial.

BACKGROUND: Sentinel lymph node (SLN) biopsy is the standard care for early detection and staging of lymph node metastasis in melanomas. Radiocolloids (RC) and blue dyes are used for SLN detection. Recently, near infrared (NIR) fluorescence tracing using indocyanine green has been developed as an alternative method for SLN detection. The relatively high tissue penetration depth of several millimeters and the ability to detect low concentrations of tracer both suggest that NIR may have significant advantages over RC and the blue dye methods. The objective of this study was to prospectively compare the performance of all three SLN detection techniques using them sequentially to evaluate the same group of patients. METHODS: One hundred twenty-one primary cutaneous melanoma patients with an indication for SLN biopsy were assigned to the procedure following NIR, blue dye, and RC detection techniques. RESULTS: No adverse event was reported. SLN was not detected in only 4.1% of cases. In 90.9%, an SLN was identified with NIR, but without any auxiliary technique in only 70.2% of cases. RC detected the SLN in 92.6% of cases. Patent blue was found in the sentinel node in 76.9%. The combination of all three techniques detected an SLN in 95.9% of cases. Metastases were present in 26.7%. The false-negative rate was 8.8%, with a negative predictive value of 91.2%. CONCLUSIONS: RC was the only technique with high SLN detection. Both the blue dye and NIR methods added sensitivity to the detection rate but should not be a substitute for RC.

Cross-talk between SUMOylation and ISGylation in response to interferon.

Interferon (IFN) plays a central role in regulating host immune response to viral pathogens through the induction of IFN-Stimulated Genes (ISGs). IFN also enhances cellular SUMOylation and ISGylation, though the functional interplay between these modifications remains unclear. Here, we used a system-level approach to profile global changes in protein abundance in SUMO3-expressing cells stimulated by IFNα. These analyses revealed the stabilization of several ISG factors including SAMHD1, MxB, GBP1, GBP5, Tetherin/BST2 and members of IFITM, IFIT and IFI families. This process was correlated with enhanced IFNα-induced anti-HIV-1 and HSV-1 activities. Also IFNα upregulated protein ISGylation through increased abundance of E2 conjugating enzyme UBE2L6, and E3 ISG15 ligases TRIM25 and HERC5. Remarkably, TRIM25 depletion blocked SUMO3-dependent protein stabilization in response to IFNα. Our data identify a new mechanism by which SUMO3 regulates ISG product stability and reinforces the relevance of the SUMO pathway in controlling both the expression and functions of the restriction factors and IFN antiviral response.

Characteristics of Brazilian melanomas: real-world results before and after the introduction of new therapies.

OBJECTIVE: This study is a characterization of the treatment patterns and outcomes of a Brazilian melanoma cohort collected of 1848 patients enrolled between 1996 and 2015. RESULTS: The superficial spreading subtype (35.1%) was the most prevalent, and the favoured anatomical location was the trunk (32.8%). The most common clinical stage was I (27.6%). The most frequent initial treatment was surgery (84.7%). Sentinel node biopsy was positive in 23.3% of cases. Chemotherapy was used to treat 298 patients (16.1%), immunotherapy for 67 (3.6%) and targeted therapy for 19 (1.0%). Distant recurrence was commonly observed (22.5%) and the mutation status of the BRAF gene was verified in 132 cases, with 42.4% positivity in this subset of patients. The melanoma specific actuarial 5-year survival for the cohort was 68.8%. There was a higher 5-year survival observed in metastatic melanoma patients who received immunotherapy and/or targeted therapy (34.2%) compared patients treated with just chemotherapy (20.0%). The survival analysis showed that sex, age, Breslow, clinical stage and distant recurrence were significant prognostic factors. This study provides a real-world description of how the introduction of new therapies such as immunotherapy and BRAF inhibitors is changing treatment strategies for melanoma in developing countries.

Comparative analysis of glutathione transferase genetic polymorphism, Helicobacter pylori and Epstein-Barr virus between the tumor area and the proximal and distal resection margins of gastric cancer. / Análise comparativa do polimorfismo genético da glutationa transferase, do Helicobacter pylori e do vírus Epstein-Barr entre a área do tumor e as margens de ressecção proximal e distal do câncer gástrico.

OBJECTIVE: to compare the polymorphism of the Glutathione S-transferase theta 1 (GSTT1) and Glutathione S-transferase mu 1 (GSTM1) genes from the tumor area with the proximal and distal margins of stomach specimens resected from patients with gastric cancer, and to investigate the presence of Epstein-Barr virus (EBV) DNA and Helicobacter pylori. METHODS: we prospectively collected tissue specimens from the tumor area and from the proximal and distal resection margins of the stomachs of ten patients with gastric adenocarcinoma who underwent gastrectomy with D2 lymphadenectomy, and submitted these specimens to DNA extraction. We compared the tumor area with the proximal and distal margins of the resected stomachs for polymorphism of GSTT1 and GSTM1 genes and investigated the presence of EBV-DNA and H. pylori. We used the p53 exon 5 gene as an internal control of the multiplex PCR reaction. RESULTS: in one patient, we detected null GSTT1 and GSTM1 genotypes in the tumor area, in contrast to the presence of both genes in the proximal and distal margins. We found EBV-DNA and H. pylori in the tumor area and also in the proximal and distal margins. In another patient, the proximal margin was negative for GSTT1, and EBV-DNA was negative in the distal margin. In three patients, EBV-DNA was negative only in the distal margin. CONCLUSION: this is the first report where different genotypes, EBV-DNA and H. pylori infection were observed in the same patient, indicating a probable deletion of these genes in response to tumor progression and intratumoral heterogeneity.

OBJETIVO: comparar o polimorfismo dos genes Glutationa S-transferase teta 1 (GSTT1) e Glutationa S-transferase mu 1 (GSTM1) da área do tumor com as margens proximal e distal de espécimes de estômago ressecados de pacientes com câncer gástrico, e investigar a presença do DNA do vírus Epstein-Barr (EBV) e Helicobacter pylori. MÉTODOS: coletamos prospectivamente amostras teciduais da área do tumor e das margens de ressecção proximal e distal dos estômagos de dez pacientes com adenocarcinoma gástrico submetidos à gastrectomia com linfadenectomia D2 e submetemos esses espécimes à extração de DNA. Comparamos a área do tumor com as margens proximal e distal dos estômagos ressecados para o polimorfismo dos genes GSTT1 e GSTM1 e investigamos a presença de DNA do EBV e H. pylori. Utilizamos o exon 5 do gene p53 como controle interno da reação de PCR multiplex. RESULTADOS: em um paciente, detectamos genótipos GSTT1 e GSTM1 nulos na área do tumor, em contraste com a presença de ambos os genes nas margens proximal e distal. Encontramos DNA do EBV e H. pylori na área do tumor e também nas margens proximal e distal. Em outro paciente, a margem proximal foi negativa para GSTT1 e o DNA do EBV foi negativo na margem distal. Em três pacientes, o EBV-DNA foi negativo apenas na margem distal. CONCLUSÃO: este é o primeiro relato em que diferentes genótipos, infecção por EBV-DNA e H. pylori foram observados no mesmo paciente, indicando provável deleção desses genes em resposta à progressão tumoral e heterogeneidade intratumoral.

Análise comparativa do polimorfismo genético da glutationa transferase, do Helicobacter pylori e do vírus Epstein-Barr entre a área do tumor e as margens de ressecção proximal e distal do câncer gástrico / Comparative analysis of glutathione transferase genetic polymorphism, Helicobacter pylori and Epstein-Barr virus between the tumor area and the proximal and distal resection margins of gastric cancer

RESUMO Objetivo: comparar o polimorfismo dos genes Glutationa S-transferase teta 1 (GSTT1) e Glutationa S-transferase mu 1 (GSTM1) da área do tumor com as margens proximal e distal de espécimes de estômago ressecados de pacientes com câncer gástrico, e investigar a presença do DNA do vírus Epstein-Barr (EBV) e Helicobacter pylori. Métodos: coletamos prospectivamente amostras teciduais da área do tumor e das margens de ressecção proximal e distal dos estômagos de dez pacientes com adenocarcinoma gástrico submetidos à gastrectomia com linfadenectomia D2 e submetemos esses espécimes à extração de DNA. Comparamos a área do tumor com as margens proximal e distal dos estômagos ressecados para o polimorfismo dos genes GSTT1 e GSTM1 e investigamos a presença de DNA do EBV e H. pylori. Utilizamos o exon 5 do gene p53 como controle interno da reação de PCR multiplex. Resultados: em um paciente, detectamos genótipos GSTT1 e GSTM1 nulos na área do tumor, em contraste com a presença de ambos os genes nas margens proximal e distal. Encontramos DNA do EBV e H. pylori na área do tumor e também nas margens proximal e distal. Em outro paciente, a margem proximal foi negativa para GSTT1 e o DNA do EBV foi negativo na margem distal. Em três pacientes, o EBV-DNA foi negativo apenas na margem distal. Conclusão: este é o primeiro relato em que diferentes genótipos, infecção por EBV-DNA e H. pylori foram observados no mesmo paciente, indicando provável deleção desses genes em resposta à progressão tumoral e heterogeneidade intratumoral.

ABSTRACT Objective: to compare the polymorphism of the Glutathione S-transferase theta 1 (GSTT1) and Glutathione S-transferase mu 1 (GSTM1) genes from the tumor area with the proximal and distal margins of stomach specimens resected from patients with gastric cancer, and to investigate the presence of Epstein-Barr virus (EBV) DNA and Helicobacter pylori. Methods: we prospectively collected tissue specimens from the tumor area and from the proximal and distal resection margins of the stomachs of ten patients with gastric adenocarcinoma who underwent gastrectomy with D2 lymphadenectomy, and submitted these specimens to DNA extraction. We compared the tumor area with the proximal and distal margins of the resected stomachs for polymorphism of GSTT1 and GSTM1 genes and investigated the presence of EBV-DNA and H. pylori. We used the p53 exon 5 gene as an internal control of the multiplex PCR reaction. Results: in one patient, we detected null GSTT1 and GSTM1 genotypes in the tumor area, in contrast to the presence of both genes in the proximal and distal margins. We found EBV-DNA and H. pylori in the tumor area and also in the proximal and distal margins. In another patient, the proximal margin was negative for GSTT1, and EBV-DNA was negative in the distal margin. In three patients, EBV-DNA was negative only in the distal margin. Conclusion: this is the first report where different genotypes, EBV-DNA and H. pylori infection were observed in the same patient, indicating a probable deletion of these genes in response to tumor progression and intratumoral heterogeneity.

JC and BK virus DNA detection in archival slides of urine cytospin from renal transplant patients.

BACKGROUND: Although identifying cytological viral inclusions (decoy cells) in the urine is relatively easy, distinguishing between Polyomaviruses BKV and JCV is not possible. Few studies have been published regarding JCV detection in kidney transplant recipients. OBJECTIVE: To evaluate the incidence of BKV and JCV DNA in archival slides of urine cytospin material from renal transplant patients. METHODS: A total of 44 urine specimens were evaluated cytologically for the presence of viral inclusions (decoy cells) and by nested polymerase chain reaction to differentiate between JCV and BKV in DNA isolated from archival slides of urine cytospin material. RESULTS: Of the 44 urine specimen donors, 9 (20.5%) patients had at least 1 sample with alterations suggestive of or compatible with viral infection (decoy cells), and 3 had urine samples with cellular atypias/neoplasias. Additionally, 24/44 (54.5%) patients had PCR-positive DNA for Polyomavirus in at least 1 sample, including 11/44 who were positive for BKV (25%) and 16/44 who were positive for JCV (36.36%), with 3 (6.8%) patients showing viral coinfection. Regarding transplantation time, only JCV was statistically significant (P = .019) for periods longer than 10 years. CONCLUSIONS: The results highlight the potential use of archival slides of urine cytospin material to differentiate BKV and JCV and demonstrate the importance of improved JCV detection for later kidney transplant recipients.

DNA detection of JC and BK virus in archival urine cytospin slides.

To identify decoy cells, cytological examination was performed in urine cytospin slides. Decoy cells are related to Polyomaviruses (JC virus [JCV] and BK virus [BKV]), which are recognized worldwide due to potential infection and morbidity in kidney transplant recipients. Cytologically, it is difficult to evaluate the cytopathic effect of JCV and BKV in urine of patients with urothelial neoplasia. For this reason, there is a need for molecular approaches. To evaluate the incidence of BKV and JCV DNA in archival slides of urine cytospin material with benign and malignant characteristics. A total of 176 urine specimens were used for cytological examination of neoplastic or decoy cells. The samples were analyzed for the presence of JCV and BKV, by polymerase chain reaction (PCR) in DNA Isolated from archival slides of urine cytospin material. A typical samples (n = 48) were compared with the remaining 128 samples without atypia/neoplasia for the presence of JCV or BKV DNA. A statistically nonsignificant result was observed correlating the presence of JCV or BKV. The results show that DNA Isolated from archival slides of urine cytospin material can be used for detection of BKV and JCV.

Comparing intestinal versus diffuse gastric cancer using a PEFF-oriented proteomic pipeline.

Gastric cancer is the fifth most common malignant neoplasia and the third leading cause of cancer death worldwide. Mac-Cormick et al. recently showed the importance of considering the anatomical region of the tumor in proteomic gastric cancer studies; more differences were found between distinct anatomical regions than when comparing healthy versus diseased tissue. Thus, failing to consider the anatomical region could lead to differential proteins that are not disease specific. With this as motivation, we compared the proteomic profiles of intestinal and diffuse adenocarcinoma from the same anatomical region, the corpus. To achieve this, we used isobaric labeling (iTRAQ) of peptides, a 10-step HILIC fractionation, and reversed-phase nano-chromatography coupled online with a Q-Exactive Plus mass spectrometer. We updated PatternLab to take advantage of the new Comet-PEFF search engine that enables identifying post-translational modifications and mutations included in neXtProt's PSI Extended FASTA Format (PEFF) metadata. Our pipeline then uses a text-mining tool that automatically extracts PubMed IDs from the proteomic result metadata and drills down keywords from manuscripts related with the biological processes at hand. Our results disclose important proteins such as apolipoprotein B-100, S100 and 14-3-3 proteins, among many others, highlighting the different pathways enriched by each cancer type. SIGNIFICANCE: Gastric cancer is a heterogeneous and multifactorial disease responsible for a significant number of deaths every year. Despite the constant improvement of surgical techniques and multimodal treatments, survival rates are low, mostly due to limited diagnostic techniques and late symptoms. Intestinal and diffuse types of gastric cancer have distinct clinical and pathological characteristics; yet little is known about the molecular mechanisms regulating these two types of gastric tumors. Here we compared the proteomic profile of diffuse and intestinal types of gastric cancer from the same anatomical location, the corpus, from four male patients. This methodological design aimed to eliminate proteomic variations resulting from comparison of tumors from distinct anatomical regions. Our PEFF-tailored proteomic pipeline significantly increased the identifications as when compared to previous versions of PatternLab.

Comparação do controle postural em cinco tarefas de equílibrio e a relação dos riscos de quedas entre idosas e adultas jovens / Comparación del control postural en cinco tareas de equilibrio y la relación de los riesgos de caídas entre ancianas y adultas jovenes / Comparison of postural control in five tasks of balance and relation of risk of falls between older and young adult women

RESUMO O envelhecimento é um processo natural que acarreta mudanças intrínsecas e extrínsecas ao organismo. O objetivo é analisar cinco tarefas de equilíbrio postural em idosas através da Plataforma de força, correlacionando com o risco de quedas avaliado pelo teste Timed Up and Go (TUG). Participaram do estudo 43 idosos e 40 adultos jovens, todos do sexo feminino, que foram avaliadas em uma plataforma de força com um protocolo padrão: descalças, com os braços ao longo do corpo nas tarefas bipodal e semitandem, ambos olhos abertos e fechados, apoio unipodal utilizando o centro de oscilação postural (COP) e as velocidades nos eixos anteroposterior (Vel AP) e médio-lateral (Vel ML). Após 5 minutos de descanso, realizou-se o TUG. Os resultados mostraram que as idosas tiveram maior instabilidade postural (p<0.05) em relação às adultas jovens, e a tarefa que mais desafiou o equilíbrio foi o apoio unipodal COP 10,02 (cm2) Vel AP 3,00 (cm/s) e Vel ML 3,32 (cm/s), e as idosas tiveram um tempo médio no TUG de 9,01 segundos considerando um baixo risco de quedas. Conclusão: Idosas apresentam um maior déficit no equilíbrio em relação às jovens, sendo a tarefa de apoio UNP a que mais apresentou desafios no controle postural das duas populações. Idosas saudáveis apresentaram um baixo risco para as quedas, nenhuma correlação foi encontrada entre o equilíbrio postural através da plataforma de força e risco de quedas do TUG.

RESUMEN El envejecimiento es un proceso natural, lo cual conlleva cambios intrínsecos e extrínsecos en el organismo. El objectivo es analizar cinco tareas de equilibrio postural en ancianas por medio de la plataforma de fuerza, presentándose correlación con el riesgo de caídas evaluado por el Timed Up and Go Test (TUGT). Participaron del estudio 43 ancianas y 40 adultas jovenes, las cuales fueron evaluadas en una plataforma de fuerza con un protocolo patrón: descalzas, con los brazos al longo del cuerpo en las tareas bipodal y semi-tandem, ambos ojos abiertos y cerrados, apoyo unipodal utilizando el centro de oscilación postural (COP) y las velocidades en los ejes anteroposterior (Vel AP) y mediolateral (Vel ML). Después de 5 minutos de descanso, se realizó el TUGT. Los resultados presentaron que las ancianas tuvieron mayor inestabilidad postural (p<0.05) en relación a las adultas jovenes, y la tarea que más desafió el equilibrio fue el apoyo unipodal COP 10,02 (cm2) Vel AP 3,00 (cm/s) y Vel ML 3,32 (cm/s), y las ancianas tuvieron un tiempo medio en el TUGT de 9,01 segundos considerando bajo riesgo de caídas. La conclusión es que ancianas presentan mayor déficit en el equilibrio en relación a las jovenes, siendo la tarea de apoyo UNP la que más presentó desafíos en el control postural de las dos poblaciones. Ancianas saludables presentaron bajo riesgo para las caídas, ninguna correlación fue encontrada entre el equilibrio postural por medio de la plataforma de fuerza y riesgo de caídas del TUGT.

ABSTRACT Aging is a natural process, which involves intrinsic and extrinsic changes in the organism. The objective is to analyze five tasks of postural balance in older women through the strength platform, correlating them with risk of falls evaluated by the Timed Up and Go (TUG) test. Participants of this study were 43 older women and 40 young adult women. They were evaluated on a force platform with a standard protocol: barefoot with arms along the body in Semi-Tandem and bipedal stances, with both eyes open and then closed, unipedal support using the postural sway of the center of pressure (COP) and the velocities in the anteroposterior axis (AP) and medial-lateral (ML). After 5 minutes of rest, TUGT was applied. The results showed that older women had greater postural instability (p<0.05) than younger women. The most challenging task for balance was unipedal support COP: 10.02(cm2); AP velocity: 3.00 (cm/s); ML velocity: 3.32 (cm/s). Older women needed a mean time of 9.01 seconds in the TUGT, considering a low risk of falls. Conclusion: Older women present a higher deficit in their balance compared with young women, so as Unipedal Stance Test (UPST) task was the most challenging for postural control of the two populations. Healthy older women presented a low risk for falls. No correlation was found between postural balance through the force platform and risk of falls during the TUGT.

Considerations about gastric cancer proteomics.

The frequency of molecular studies aimed to analyze promoter methylation of tumor suppressor genes and global proteomics in gastric carcinogenesis is increasing. Nonetheless, only a few considered the different types of stomach cells, the tumor location and the influence of Helicobacter pylori and Epstein Barr virus infection (EBV). Molecular differences relating to anatomical and histological tumor areas were also recently described. The authors propose a molecular classification of gastric cancer, dividing it into four subtypes: tumors positive for EBV; microsatellite unstable tumors; genomically stable tumors and tumors with chromosomal instability. RESUMO A frequência de estudos moleculares visando a analisar os promotores de metilação de genes supressores de tumor e proteômica globais na carcinogênese gástrica está aumentando. No entanto, apenas alguns consideraram os diferentes tipos de células do estômago, a localização do tumor e a influência da infecção por Helicobacter pylori e pelo vírus Epstein-Barr (EBV). Diferenças moleculares relacionadas com áreas tumorais anatômicas e histológicas também foram recentemente descritas. Os autores propõem uma classificação molecular de câncer gástrico, dividindo-o em quatro subtipos: tumores positivos para o EBV; tumores microssatélite instáveis; tumores genomicamente estáveis ​​e tumores com instabilidade cromossômica.

Sentinel Lymph Node Navigation Surgery for Early Gastric Cancer: Is It a Safe Procedure in Countries with Non-Endemic Gastric Cancer Levels? A Preliminary Experience.

PURPOSE: Early diagnosis of gastric cancer is still the exception in Western countries. In the East, as in Japan and Korea, this disease is an endemic disorder. More conservative surgical procedures are frequently performed in early gastric cancer cases in these countries where sentinel lymph node navigation surgery is becoming a safe option for some patients. This study aims to evaluate preliminary outcomes of patients with early gastric cancer who underwent sentinel node navigation surgeries in Brazil, a country with non-endemic gastric cancer levels. MATERIALS AND METHODS: From September 2008 to March 2014, 14 out of 205 gastric cancer patients underwent sentinel lymph node navigation surgeries, which were performed using intraoperative, endoscopic, and peritumoral injection of patent blue dye. RESULTS: Antrectomies with Billroth I gastroduodenostomies were performed in seven patients with distal tumors. The other seven patients underwent wedge resections. Sentinel basin resections were performed in four patients, and lymphadenectomies were extended to stations 7, 8, and 9 in the other 10. Two patients received false-negative results from sentinel node biopsies, and one of those patients had micrometastasis. There was one postoperative death from liver failure in a cirrhotic patient. Another cirrhotic patient died after two years without recurrence of gastric cancer, also from liver failure. All other patients were followed-up for 13 to 79 months with no evidence of recurrence. CONCLUSIONS: Sentinel lymph node navigation surgery appears to be a safe procedure in a country with non-endemic levels of gastric cancer.

Antimicrobial activity of the essential oil of Tetradenia riparia (Hochst.) Codd. (Lamiaceae) against cariogenic bacteria.

In Brazilian folk medicine, Tetradenia riparia (Hochst.) Codd. (Lamiaceae) is used to treat toothaches and dental abscesses and diseases induced by worms, bacteria, or fungi. This paper aims to investigate the chemical composition and the antibacterial effects of the essential oil obtained from Tetradenia riparia leaves (TR-EO) grown in Southeastern Brazil against a representative panel of oral pathogens. We evaluated the antibacterial activity of TR-EO in terms of the minimal inhibitory concentration (MIC). We identified aromadendrene oxide (14.0%), (E,E)-farnesol (13.6%), dronabinol (12.5%), and fenchone (6.2%) as the major constituents of TR-EO. TR-EO displayed MIC values between 31.2 and 500 µg/mL, with the lowest MIC value being obtained against Streptococcus mitis (31.2 µg/mL), S. mutans (62.5 µg/mL), S. sobrinus (31.2 µg/mL), and Lactobacillus casei (62.5 µg/mL). In time-kill experiments, TR-EO demonstrated bactericidal activity against S. mutans within the first 12 h, resulting in a curve profile similar to that of chlorhexidine. These results revealed that the essential oil of Tetradenia riparia displays promising activity against most of the selected cariogenic bacteria, including Streptococcus mutans.

Antimicrobial activity of the essential oil of Tetradenia riparia (Hochst.) Codd. (Lamiaceae) against cariogenic bacteria

In Brazilian folk medicine, Tetradenia riparia (Hochst.) Codd. (Lamiaceae) is used to treat toothaches and dental abscesses and diseases induced by worms, bacteria, or fungi. This paper aims to investigate the chemical composition and the antibacterial effects of the essential oil obtained from Tetradenia riparia leaves (TR-EO) grown in Southeastern Brazil against a representative panel of oral pathogens. We evaluated the antibacterial activity of TR-EO in terms of the minimal inhibitory concentration (MIC). We identified aromadendrene oxide (14.0%), (E,E)-farnesol (13.6%), dronabinol (12.5%), and fenchone (6.2%) as the major constituents of TR-EO. TR-EO displayed MIC values between 31.2 and 500 μg/mL, with the lowest MIC value being obtained against Streptococcus mitis (31.2 μg/mL), S. mutans (62.5 μg/mL), S. sobrinus (31.2 μg/mL), and Lactobacillus casei (62.5 μg/mL). In time-kill experiments, TR-EO demonstrated bactericidal activity against S. mutans within the first 12 h, resulting in a curve profile similar to that of chlorhexidine. These results revealed that the essential oil of Tetradenia riparia displays promising activity against most of the selected cariogenic bacteria, including Streptococcus mutans.

Lymph node metastasis in early gastric cancer.

OBJECTIVE: to evaluate the incidence of lymph node metastasis in early gastric cancer, identifying risk factors for its development. METHODS: we conducted a prospective study of patients with gastric cancer admitted to the Section of the Esophago-Gastric Surgery of the Surgery of Service HUCFF-UFRJ, from January 2006 to May 2012. RESULTS: the rate of early gastric cancer was 16.3%. The incidence of nodal metastases was 30.8% and occurred more frequently in patients with tumors with involvement of the submucosa (42.9%), in those poorly differentiated (36.4%), in tumors larger than 2 cm (33.3%) and in type III ulcerated lesions (43.8%). CONCLUSION: the incidence of lymph node metastases in patients was very high and suggests that one should keep the radicality of resection in early gastric cancer, particularly in relation to D2 lymphadenectomy, recommended for advanced gastric cancer. Conservative resections, with lymphadenectomies smaller than D2, should be performed only in selected cases, well-studied as for the risk factors of lymph node metastasis. Despite the small number of cases did not permit to relate the rate of lymph node metastasis to the risk factors considered, we noted a strong tendency for the occurrence of these metastases in the poorly differentiated, type III, larger than 2 cm tumors, and in the Lauren diffuse types.

Lymph node metastasis in early gastric cancer / Metástase linfonodal em câncer gástrico precoce

OBJECTIVE: to evaluate the incidence of lymph node metastasis in early gastric cancer, identifying risk factors for its development. METHODS: we conducted a prospective study of patients with gastric cancer admitted to the Section of the Esophago-Gastric Surgery of the Surgery of Service HUCFF-UFRJ, from January 2006 to May 2012. RESULTS: the rate of early gastric cancer was 16.3%. The incidence of nodal metastases was 30.8% and occurred more frequently in patients with tumors with involvement of the submucosa (42.9%), in those poorly differentiated (36.4%), in tumors larger than 2 cm (33.3%) and in type III ulcerated lesions (43.8%). CONCLUSION: the incidence of lymph node metastases in patients was very high and suggests that one should keep the radicality of resection in early gastric cancer, particularly in relation to D2 lymphadenectomy, recommended for advanced gastric cancer. Conservative resections, with lymphadenectomies smaller than D2, should be performed only in selected cases, well-studied as for the risk factors of lymph node metastasis. Despite the small number of cases did not permit to relate the rate of lymph node metastasis to the risk factors considered, we noted a strong tendency for the occurrence of these metastases in the poorly differentiated, type III, larger than 2 cm tumors, and in the Lauren diffuse types. .

OBJETIVO: avaliar a incidência de metástases linfonodais no câncer gástrico precoce identificaando fatores de risco para o surgimento destas metástases. MÉTODOS: estudo prospectivo de pacientes portadores de câncer gástrico, internados na Seção de Cirurgia Esôfago-Gástrica do Serviço de Cirurgia Geral do HUCFF-UFRJ, no período de janeiro de 2006 a maio de 2012. RESULTADOS: a frequência de câncer gástrico precoce foi 16,3%. A incidência de metástases ganglionares foi 30,8% e ocorreu com maior frequência nos pacientes portadores de tumores com comprometimento da submucosa (42,9%), naqueles pouco diferenciados (36,4%), nos tumores maiores que 2cm (33,3%) e nas lesões ulceradas do tipo III (43,8%). CONCLUSÃO: a incidência de metástases linfonodais entre os pacientes foi muito alta e sugere que se deva manter, no câncer gástrico precoce, a radicalidade das ressecções, particularmente no que se refere à linfadenectomia D2, preconizada para o câncer gástrico avançado. Ressecções conservadoras, com linfadenectomias menores que D2 devem ser realizadas apenas em casos selecionados, bem estudados quanto aos fatores de risco de metástases linfonodais. Apesar do pequeno número de casos não ter permitido relacionar o índice de metástases linfonodais aos fatores de risco estudados, pôde-se verificar uma forte tendência à ocorrência destas metástases em tumores do tipo III, maiores que 2cm, pouco diferenciados e do tipo difuso de Lauren. .

Minor gastric resections with modified lymphadenectomy in early gastric cancer with negative sentinel node.

OBJECTIVE: To study the sentinel lymph node in early gastric cancer as a diagnostic method of unsuspected lymph node metastasis, which may allow the performance, in those with negative lymph nodes, of smaller gastric resections with limited lymphadenectomy. METHODS: We studied seven patients with early gastric cancer treated at the Hospital Universitário Clementino Fraga Filho, Federal University of Rio de Janeiro, from September 2008 to May 2011, who underwent sentinel lymph node exams, performed by intraoperative peritumoral endoscopic injection of patent blue dye. RESULTS: We found an average of three sentinel nodes per patient. The frozen biopsy of lymph nodes was negative for metastases, which allowed the realization of atypical gastric resection in three cases and antrectomy with BI reconstruction in four. The performed lymphadenectomy was modified D1. There was no operative mortality. The duration of postoperative follow-up ranged from five to 37 months, without evidence of recurrence. One patient developed a second early tumor 13 months after the initial surgery and underwent total gastrectomy. CONCLUSION: The sentinel lymph node in early gastric cancer proved to be an effective method for the evaluation of nodal metastases in seven patients and allowed for smaller gastric resections and limited lymphadenectomies. These minor procedures reduce the risk of postoperative complications, maintaining, on the other hand, the oncological radicality that is required in the treatment of gastric cancer.